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VIENGKEO CHANTHALOTH- PHASOUK, LCSW

LCSW

Clinical Social Worker

NPI: 1366920811IndividualAccepts Medicare

Specialties, Licenses & Credentials

Counselor

Counselor

Code: 101Y00000X

Clinical Social WorkerPrimary

Social Worker — Clinical

Code: 1041C0700X

149.022418(IL)

CMS Specialties

PrimaryCLINICAL SOCIAL WORKER

Education

OTHER

Class of 2014

Contact & Hours

Address
2704 N MAIN ST
ROCKFORD, IL 61103

Quick Facts

NPI
1366920811
Entity Type
Individual
Gender
Female
Medicare
Accepted
Specialties
2
Locations
1
Years in Practice
12

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